Biomechanical Basis of Mild Traumatic Brain Injury

描述(申请人提供)：与运动相关的轻度创伤性脑损伤(MTBI或脑震荡)是一个重要的公共卫生问题，因为这些损伤的发生率很高，受伤的人相对年轻，可能长期残疾，反复发生的累积效应的危险，以及预防战略无效。我们建议开发和验证一个头部撞击加速的量化模型，该模型使新的临床和治疗技术的翻译研究和开发能够减少MTBI的发生率和负面影响。团队成员之间的实验、临床和产品开发项目将允许针对MTBI潜在的病理机制和临床后遗症进行假设驱动的研究。研究脑震荡的病理机制的关键是获得实际的头部加速度和由于撞击而暴露的情况。头部撞击遥测系统(HIT系统)技术是以前开发和验证的，用于现场测量头部撞击加速度。这项技术将首次实现对闭合性脑损伤受试者的生物力学、临床和神经心理学数据的前瞻性研究，允许直接测量损伤参数及其临床后果。在大学橄榄球运动员和男女大学曲棍球运动员的研究人群中，这项建议的三个具体目标是：1)改进HIT系统，用于大规模记录、存储和检索现场头部撞击加速数据；2)使用HIT系统量化头部撞击加速度，以测试关于MTBI损伤耐受能力的假设，以及累积冲击和性别是否影响这些耐力；3)将头部撞击加速与MTBI相关的临床变量关联起来，使用经过验证的边线评估、神经测试和fMRI等临床工具，验证头部加速增加脑震荡患者相对于匹配对照组的短期脑损伤测量的假设。这些研究的结果将为实现长期目标提供科学依据，以开发和部署新的战略，以改进MTBI的检测、预防、降低发病率和改进治疗。

DESCRIPTION (provided by applicant): Sports-related mild traumatic brain injury (MTBI or concussion) is an important public health problem because of the high incidence of these injuries, the relative youth of those being injured with possible long term disability, the danger of cumulative effects from repeat incidences, and ineffective strategies for prevention. We propose to develop and validate a quantitative model of head impact acceleration that enables translational research and development of new clinical and therapeutic techniques to reduce the incidence and negative effects of MTBI. Experimental, clinical and product development projects among team members will allow hypothesis-driven research specific to the underlying pathomechanics and clinical sequelae of MTBI. Crucial to the study of the pathomechanics of concussion is the acquisition of actual head accelerations and exposures due to impact. Head Impact Telemetry System (HIT System) technology was previously developed and validated for measuring head impact accelerations in the field. This technology will, for the first time, enable prospective studies of biomechanical, clinical, and neuropsychological data in human subjects with closed head injury, allowing for direct measurement of injury parameters and their clinical consequences. Within a study population of collegiate football players and male and female collegiate hockey players, the three specific aims of this proposal are: 1) improve HIT system for large-scale recording, storage, and retrieval of on-field head impact acceleration data, 2) quantify head impact acceleration using HIT system to test hypotheses on the impact tolerance to MTBI injury and whether cumulative impacts or gender influence these tolerances, and 3) correlate head impact acceleration with clinical variables related to MTBI to test the hypothesis that increased head acceleration increases short-term measures of brain injury for concussed players relative to matched controls using validated sideline and clinical tools including standardized sideline assessments, neuropsychological testing, and fMRI. The results of these studies will provide the scientific basis for achieving long-term goals to develop and deploy novel strategies to improve detection, prevention, reduce the incidence, and improve treatment of MTBI.